Raju Kanukula1, Abdul Salam1, Anthony Rodgers2,3,4, Bishoy Kamel5,6. 1. The George Institute for Global Health, Hyderabad, India. 2. The George Institute for Global Health, Sydney, NSW, Australia. 3. Faculty of Medicine, UNSW, Sydney, NSW, Australia. 4. Faculty of Medicine, University of Sydney, Sydney, NSW, Australia. 5. The George Institute for Global Health, Sydney, NSW, Australia. bishoy.kamel@unsw.edu.au. 6. St Vincent's Clinical School, Faculty of Medicine, UNSW Sydney, Level 2 Xavier Building, St Vincent's Hospital, 390 Victoria Street, Darlinghurst, Sydney, NSW, 2010, Australia. bishoy.kamel@unsw.edu.au.
Abstract
BACKGROUND: Rosuvastatin is a lipid-lowering drug that works by inhibiting 3-hydroxy-3-methylglutaryl coenzyme A reductase, the rate-limiting enzyme responsible for producing cholesterol in humans. The pharmacokinetic data of rosuvastatin are considerably variable across studies. OBJECTIVE: To review the pharmacokinetics of rosuvastatin from randomised controlled trials (RCTs) in healthy adults. METHODS: A review of the pharmacokinetics of rosuvastatin was performed using systematic search strategies. The Sheiner method was used to summarise the pharmacokinetics of the drug. RESULTS: Randomised controlled studies (n = 70) involving healthy subjects (n = 2355) that examined the pharmacokinetics of rosuvastatin following single and multiple doses were included in the review. Rosuvastatin is given once daily in the dose range of 5-80 mg, with 40 mg being the maximum approved daily dose. Rosuvastatin achieves maximum plasma concentration at a median of 5 h (range: 0.5-6 h) under fasting conditions following single and multiple doses. Following single doses, rosuvastatin has a mean absolute oral availability of 20%, an overall mean total clearance of 28.3 L/h and an average terminal elimination half-life of approximately 20 h. The overall mean total clearance of the drug in Caucasian subjects was 1.7-fold higher than that in healthy Chinese subjects. The systemic exposure of rosuvastatin is characterised by a large coefficient of variation (48%.) There is a small accumulation with repeated dosing. The interaction of rosuvastatin with darunavir/ritonavir was considered statistically and clinically relevant. Interactions of rosuvastatin single doses with erythromycin, fluconazole, itraconazole and antacid were statistically significant. DISCUSSION AND CONCLUSIONS: There is considerable variation in the pharmacokinetics of rosuvastatin between races. The clinical relevance of the statistically significant drug interactions is yet to be investigated following repeated co-administration for at least 15 days, consistent with a half-life of low-density lipoprotein of 3 days.
BACKGROUND:Rosuvastatin is a lipid-lowering drug that works by inhibiting 3-hydroxy-3-methylglutaryl coenzyme A reductase, the rate-limiting enzyme responsible for producing cholesterol in humans. The pharmacokinetic data of rosuvastatin are considerably variable across studies. OBJECTIVE: To review the pharmacokinetics of rosuvastatin from randomised controlled trials (RCTs) in healthy adults. METHODS: A review of the pharmacokinetics of rosuvastatin was performed using systematic search strategies. The Sheiner method was used to summarise the pharmacokinetics of the drug. RESULTS: Randomised controlled studies (n = 70) involving healthy subjects (n = 2355) that examined the pharmacokinetics of rosuvastatin following single and multiple doses were included in the review. Rosuvastatin is given once daily in the dose range of 5-80 mg, with 40 mg being the maximum approved daily dose. Rosuvastatin achieves maximum plasma concentration at a median of 5 h (range: 0.5-6 h) under fasting conditions following single and multiple doses. Following single doses, rosuvastatin has a mean absolute oral availability of 20%, an overall mean total clearance of 28.3 L/h and an average terminal elimination half-life of approximately 20 h. The overall mean total clearance of the drug in Caucasian subjects was 1.7-fold higher than that in healthy Chinese subjects. The systemic exposure of rosuvastatin is characterised by a large coefficient of variation (48%.) There is a small accumulation with repeated dosing. The interaction of rosuvastatin with darunavir/ritonavir was considered statistically and clinically relevant. Interactions of rosuvastatin single doses with erythromycin, fluconazole, itraconazole and antacid were statistically significant. DISCUSSION AND CONCLUSIONS: There is considerable variation in the pharmacokinetics of rosuvastatin between races. The clinical relevance of the statistically significant drug interactions is yet to be investigated following repeated co-administration for at least 15 days, consistent with a half-life of low-density lipoprotein of 3 days.
Authors: Paul D Martin; Mike J Warwick; Aaron L Dane; Steve J Hill; Petrina B Giles; Paul J Phillips; Eva Lenz Journal: Clin Ther Date: 2003-11 Impact factor: 3.393
Authors: Chester Costales; Jian Lin; Emi Kimoto; Shinji Yamazaki; James R Gosset; A David Rodrigues; Sarah Lazzaro; Mark A West; Michael West; Manthena V S Varma Journal: CPT Pharmacometrics Syst Pharmacol Date: 2021-07-20